Cardiology Commons^™

Evaluating Low Molecular Weight Heparin For Venous Thromboembolism Treatment In Extreme Body Weights, Natalie Tran, Brittanii Prahl, Jordan Amaro, Barbara Branneman, Jack Huber

All Poster Presentations

No abstract provided.

Evaluating The Market Withdrawal Of Andexanet Alfa, Jordyn Linfield, Addisyn Cooper, Alexander Defranco, Emma Gerding, Jessica Kelley, Tyler Henney, Connor Dains, Brenna Hissong, Brittany Bates

Pharmacy and Wellness Review

The coagulation cascade comprises intrinsic, extrinsic, and common pathways that converge when thrombin converts fibrinogen (factor I) into fibrin, leading to fibrin mesh formation, stabilization of the platelet plug, and ultimately thrombus formation. Inhibition of the coagulation cascade can be achieved with a variety of anticoagulant medications, including direct oral anticoagulants (DOACs). The mechanism of action of DOACs is to inhibit either factor Xa or thrombin. Reversal of anticoagulation remains an important clinical consideration when managing patients on DOACs who experience serious bleeding events. Andexanet alfa is a recombinant, modified human factor Xa protein previously indicated for patients receiving rivaroxaban …

Fda Approval Of Etripamil For The Treatment Of Paroxysmal Supraventricular Tachycardia, Kiley Devoll, Daniella Egbujor, Katy Grainger, Katherine Cook, Victoria Niese, Connor Dains, Brenna Hissong, Andrew Roecker

Pharmacy and Wellness Review

Paroxysmal supraventricular tachycardia (PSVT) is characterized by sudden, brief, intermittent episodes that result in a heart rate of 150 to 250 beats per minute (bpm). PSVT is difficult to diagnose, making proper treatment challenging. According to the 2015 American Heart Association (AHA)/American College of Cardiology (ACC)/Heart Rhythm Society (HRS) guidelines, current pharmacologic recommendations for PSVT include adenosine, verapamil, diltiazem, or nonpharmacologic vagal maneuvers.¹ These treatments each have a variety of adverse effects, contraindications, and dosing considerations, which highlight a need for novel therapies for the acute treatment and maintenance of PSVT.¹ The NODE-301 trial assessed the safety and …

2025 Novel Drug Approvals, Katherine Ghattas Pharmd, Amanda Rawa Pharmd

Transformative Medicine

The year 2025 marked another strong chapter in pharmaceutical innovation, with multiple novel therapies gaining approval from the U.S. Food and Drug Administration (FDA). These approvals reflect continued progress in addressing unmet medical needs across a wide range of disease states. This article reviews the FDA’s 2025 novel drug approvals, spotlighting a few therapeutic advancements and emerging trends. A comprehensive table of all approved agents is provided, along with a focused discussion of four particularly impactful therapies: donidalorsen (Dawnzera), taletrectinib (Ibtrozi), delgocitinib (Anzupgo), gepotidacin (Blujepa), etripamil (Cardamyst). Each of these agents represents a step forward in its respective field and …

Impact Of Multimodal Analgesia In Comparison To Conventional Analgesia In Coronary Artery Bypass Graft Patient With Implementation Of An Enhanced Recovery After Surgery Order-Set, Rhoda Musyoka, Radhan Gopalani, Maura Falli, Maria Ruiz, Cathleen Charles, Yanija Zhang, Esty Trimino, Laura Dominguez Vasquez, Tom Nguyen

Nursing & Health Sciences Research Journal

Background: An Enhanced Recovery After Surgery (ERAS) pilot program was implemented for coronary artery bypass graft (CABG) procedures under a single cardiothoracic surgeon in May 2024 across two community hospitals. We assessed the impact of multimodal analgesia facilitated through the ERAS CABG order-set compared to the non-ERAS (conventional) CABG order-set.

Methods: This study was an Institutional Review Board-approved, multi-site, retrospective chart review of participants admitted to two community hospitals for a CABG procedure from June 2024 to January 2025. Participants who utilized the preand post-ERAS or the pre- and post-conventional CABG order-sets were included. The primary outcome was the opioid …

Pharmacogenetic-Guided Antiplatelet Therapy For Personalized Medicine In Patients With Stroke And Transient Ischemic Attack Without Cardioembolic Stroke: A Systematic Review Of Economic Evaluations, Nathapol Samprasit, Chamipa Phanudulkitti, Nattanichcha Kulthanachairojana, Jatapat Hemapanpairoa

The Thai Journal of Pharmaceutical Sciences

Background: Stroke is a major global public health burden. Ischemic stroke is the most common type of all stroke cases worldwide. Antiplatelet therapy is a key strategy for secondary prevention in patients with stroke and transient ischemic attacks (TIAs) without cardioembolic stroke. Dual antiplatelet therapy (DAPT) with clopidogrel is recommended in patients with early mild stroke or high-risk TIA, followed by long-term single antiplatelet therapy (SAPT). Clopidogrel is often used as an alternative for patients with aspirin resistance or intolerance. However, clopidogrel is a prodrug metabolized by the CYP2C19 enzyme, leading to variability in its effectiveness.

Objectives: This study aims …

Pcsk-9 Inhibitors Treatment: The Cardiovascular Disparity, Julia Lees, Seana-Pierre Williams, Tahir Razzaq, Michael B. Roberts

The Journal of Integrated Primary Care

Introduction: According to the Center for Disease Control and Prevention (CDC) and American Heart Association (AHA), cardiovascular disease is the leading cause of death in the United States. This phenomenon disproportionally affects the African American population, who have a 31% higher mortality rate than non-Hispanic Caucasian individuals. A retrospective review of PCSK-9 medication use, specifically in a patient population that had minimal representation in the large, landmark clinical trials, can lead to better understanding about the therapeutic potential in cardiovascular disease reduction and patient outcomes attributed to medication use. Education regarding this novel drug class, medication access and patient support, …

Pro: The Use Of Sugammadex Does Not Preclude The Need For Objective Neuromuscular Monitoring., J Ross Renew, Dustin D. Linn

Parkview Pharmacy Department

Based on strong evidence, optimal management of neuromuscular block should incorporate objective (or quantitative) neuromuscular monitoring with appropriately dosed antagonists such as sugammadex. Sugammadex has the unique ability to antagonize aminosteroidal-induced neuromuscular block at any level; however, neostigmine is a reasonable alternative at minimal levels. Blind or excessive administration of sugammadex does not eliminate the risk of patients having postoperative residual neuromuscular block. Significant variability exists in how patients respond both to neuromuscular blocking agents and their antagonists.

Takotsubo Cardiomyopathy: A Case Of The Broken Heart, Lilian Huynh, Kaylee Putney

Annual Research Symposium

Takotsubo cardiomyopathy (TC), or "broken heart syndrome," is a rare cardiac condition causing temporary left ventricular dysfunction due to severe stress. Though the exact cause is unclear, it mimics myocardial infarction and can lead to cardiogenic shock. Current treatment lacks specific guidelines and relies on heart failure protocols. We report a case of a patient with TC-induced cardiogenic shock, likely triggered by emotional stress. She required vasopressors, a percutaneous intervention, an Impella device, and guideline-directed medication therapies. This case underscores the significance of establishing guideline optimizations for managing TC and cardiogenic shock.

The Short And Sweet On Sodium-Glucose Cotransporter Inhibitors And Glucagon-Like Peptide-1 Receptor Agonists In Heart Failure, Jose L. Batista, Tracy Makuvire, Jonathan D. Davis, Salvatore Carbone

EVMS School of Health Professions Faculty Publications

Heart failure (HF) affects 6 million people in the US, and type 2 diabetes (T2D) is a significant risk factor for HF. Since 2008, regulatory agencies have required cardiovascular safety trials for new T2D therapies, and these have consistently demonstrated the cardiovascular benefits of glucose-lowering drugs. Sodium-glucose cotransporter inhibitors (SGLTi) and glucagon-like peptide-1 (GLP-1) receptor agonists (RAs)/glucose-dependent insulinotropic polypeptide (GIP) reduce major adverse cardiovascular events and deaths, regardless of diabetes status, and improve cardiorespiratory fitness. SGLTis, such as dapagliflozin and empagliflozin, benefit patients with reduced and preserved ejection fraction, significantly reducing HF hospitalizations and cardiovascular deaths. The DAPA-HF and EMPEROR-Reduced …

Impact Of An Interdisciplinary Team On Patients Seen At A Heart Failure Clinic, Nilda Pelegrino, Faaria Quadri, Elaina Rosario, Jacqualine Igwe, Sandra Chaparro, Lourdes Labrada, Sara Panella, Maria Pulido, Stephen Breazeale, Zhenwei Zhang

Nursing & Health Sciences Research Journal

Background: Heart failure is a complex clinical syndrome that requires the involvement of interdisciplinary teams to address patient needs and optimize therapy. Interdisciplinary teams, including physicians, advanced practice practitioners, and pharmacists, play a crucial role in implementing guideline-directed medical therapy and addressing barriers to self-care that ultimately improve patients’ overall survival. This study assessed the impact of an interdisciplinary team on patients’ heart failure outcomes compared to patients solely managed by clinical cardiologists. Methods: This was a single-center retrospective chart review study of Baptist Health patients seen at the heart failure clinic. The study compared patients seen by an interdisciplinary …

Recent Developments In Tirzepatide's Role In Reducing Cardiovascular Disease Risk Factors In Adults With Type 2 Diabetes, Talaya Jones, Zaneh Kahook, Carina Bryan, Mayur Parmar

HCA-NSU MD Research Day

Objective: This literature review aims to investigate recent developments in tirzepatide’s ability to lessen CVD risk factors for adults with increased risk of major adverse cardiovascular events. Background: Tirzepatide is an FDA - approved medication primarily used to treat adults with type 2 diabetes mellitus (T2DM) by reducing A1C and chronic weight management, however its efficacy for reducing CVD risk factors is under examination. Methods: This review synthesizes data from recent early findings published by the pharmaceutical company, which has not yet undergone peer review, alongside existing literature on tirzepatide. Additional sources were identified through a systematic search of PubMed, …

Home Blood Pressure Monitoring Bundle For Hypertension Outcomes In Adult Patients Receiving Care In Public Health Clinics, Christine Jennifer Victorian

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Background: Hypertension (HTN) that is not adequately controlled leads to cardiovascular disease, stroke, and heart disease. It affects 116 million adults (47%) in the United States (U.S.). The HTN compliance rate in a South Texas public health clinic was 64%, below the national benchmark of 76%. Home blood pressure monitoring (HBPM) was recommended in a joint statement by the American Heart Association (AHA) and the American Medical Association (AMA). Literature evidence revealed that the HBPM bundle increased BP control (< 140/90 mmHg) compliance.

Methods: A quality improvement (QI) bundle was initiated to address the low HTN compliance rate from a quality management perspective. …

Review Of Current Dual-Antiplatelet And Triple Therapy Prescribing Practices At Providence Medical Group, Gina Kim, Christine Doran, Lauren Powell

Books, Presentations, Posters, Etc.

Abstract: Approximately 10% of patients with recent percutaneous intervention (PCI) have concomitant atrial fibrillation (AF) and others may have concomitant venous thromboembolism (VTE). This makes choosing the optimal antithrombotic regimen challenging. The ACC published a 2020 decision pathway to guide safe and evidence-based use of antiplatelet and anticoagulant combinations for certain patients. These situations include patients with prior AF on anticoagulation and the need for PCI, patients with new-onset AF requiring anticoagulation in a patient already on antiplatelet therapy for coronary artery disease (CAD), patients with prior VTE on anticoagulation and the need for PCI, and patients with new or …

Role Of Midodrine On Vasopressor Duration In Patients With Sepsis, Kamah J. Ellena, Jenna L. Combs, Heather M. Draper, Julie J. Belfer

Journal of Shock and Hemodynamics

Existing literature evaluating the off-label use of midodrine has focused primarily on postoperative hypotensive patients requiring a single vasopressor. This study aimed to evaluate the impact of midodrine on vasopressor duration and length of stay in patients receiving vasopressors for sepsis-related hypotension. This is an institutional review board-approved, single-center, retrospective analysis of critically ill patients with hypotension secondary to sepsis who received midodrine and intravenous vasopressors compared to those who received intravenous vasopressors alone. Patients were matched by Acute Physiology and Chronic Health Evaluation II score, suspected source of infection, and presence of bacteremia. One hundred patients were included in …

The Impact Of Pharmacy Led Education On The Management Of Heart Failure With Preserved Ejection Fraction In The Primary Care Setting, Laura Kays, Ben Rosati, Trevor Laursen, Maurice N. Tran

Providence Pharmacy PGY2 Program at Providence Medical Group 2023

No abstract provided.

Anti-Factor Xa Level Monitoring For Enoxaparin Prophylaxis And Treatment In High-Risk Patient Groups, Lucie Sikes, Kipson Charles, Abigail Antigua, Rima Patel, Selina Imboywa, Pheba Cherian

HCA Healthcare Journal of Medicine

Monitoring anti-factor Xa levels is a controversial topic in the inpatient setting due to resource utilization and unclear conditional guideline recommendations regarding this practice. Enoxaparin dosing in certain high-risk patient populations such as those with low body weight, obesity, renal insufficiency, and pregnancy has not been determined. The objective of this review was to assess the safety and efficacy of enoxaparin monitoring via anti-factor Xa levels in high-risk patient populations.

The PubMed database was searched for articles related to low-molecular-weight heparin monitoring. Randomized controlled trials and meta-analyses that evaluated the safety and efficacy of enoxaparin prophylaxis and treatment in patients …

Qi Project: Clopidogrel In Nstemi, Amanda Sams, Erin Kaya, Carsten Kirby, Ester Peters, Michael Stewart (Faculty Advisor)

Articles, Abstracts, and Reports

No abstract provided.

A Metabolic, Mechanical, Multi-Organ Masterpiece: Dural Device Support Bridge To En-Bloc Heart-Liver Transplantation In Propionic Acidemia, Rebecca Juhl, Brian Birnbaum, Aliessa P. Barnes, William Gibson, Bhargava Mullapudi, Beth Lang, Megan Faseler, Daniel E. Heble, Victoria Urban, Ryan T. Fischer, Jennifer L. Gannon, David Sutcliffe

Posters

Introduction: Propionic Acidemia (PA) is a disorder related to abnormal protein and lipid metabolism resulting in progressive neurological injury and dilated cardiomyopathy (DCM). Interventions for PA and secondary disease manifestations can require multi-organ transplantation. Herein we report the case of a child with PA and end-stage DCM requiring left ventricular assist device (LVAD) support with eventual heart-liver transplant. Case Report: A 17 year old male diagnosed in childhood with PA developed chronically progressive DCM culminating in end stage heart failure with acute decompensations. In a recurrent admission, he progressed to require dual inotropic support and systemic anticoagulation for new LV …

Insulin Utilization In Post-Operative Open Heart Surgery Patients, Kathy Trinh, Bryce Winn, Hsin-Fang Li

Providence Pharmacy PGY1 Program at Providence Portland and Providence St. Vincent Medical Centers 2023

No abstract provided.

Integrating Pharmacists In Hfref Outpatient Care To Improve Use Of Guideline-Directed Medical Therapy, Roy Robertson Md, Mindy Flanagan Phd, Kris Howard Pharmd, Elizabeth Meisberger Pharmd, Emily Keltner Bs, Ma, Lovekirat Singh Ms, Carly Daley Phd, Shauna Wagner Bsn, Rn, Tammy Toscos Phd, Michael Mirro Md, Facc, Fhrs, Faha

Health Services and Informatics Research

Background: Guideline directed medical therapy (GDMT) is the cornerstone of reducing mortality and morbidity in patients with heart failure with reduced ejection fraction (HFrEF); however, uniform prescribing remains low. There is potential for multidisciplinary care teams, including pharmacists, to improve GDMT use in outpatient care for patients with HFrEF. Investigation is needed to understand the impact of pharmacists in outpatient HFrEF care on GDMT prescribing.

Objectives: To examine the impact of integrating a pharmacist into an outpatient cardiology setting on GDMT prescription rates during HFrEF-related clinic visits.

Methods: This retrospective chart review study examined cardiology clinic visits (HF clinic, “general …

The Impact Of Remote Optimization Of Guideline-Directed Medical Therapy In Patients With Nyha Stage Ii And Iii Heart Failure, Maurice N. Tran, Christine Doran, Trevor Laursen, Kellie Graybosch, Jacob Abraham

Providence Pharmacy PGY2 Program at Providence Medical Group 2022

No abstract provided.

Effects Of Pharmacist Intervention On Blood Pressure In Black Versus White Patients, Angela Kim, Benjamin Rosati, Dawn Fuke

Providence Pharmacy PGY2 Program at Providence Medical Group 2022

No abstract provided.

Retrospective Impact Of Covid-19 Pandemic On Hypertension Management In Primary Care, Carly Barnes, Jayme Johnston, Judy Wong

Providence Pharmacy PGY2 Program at Providence Medical Group 2022

No abstract provided.

Preoperative Phytonadione Supplementation For Mitral Valve Intervention Hemostasis, Katherine M. Nguyen, Joshua Francis, Celine Munoz, Torin P. Fitton

Providence Pharmacy PGY1 Program at Providence Portland and Providence St. Vincent Medical Centers 2022

No abstract provided.

An Evaluation Of Oral Anticoagulation Initiation After Ischemic Stroke In Patients With Atrial Fibrillation/Atrial Flutter At Hospital Discharge, Jessica Zhao, Meri Slavica, Vanessa Jenkins, Natalie Swearingen

Providence Pharmacy PGY1 Program at Providence Portland and Providence St. Vincent Medical Centers 2022

No abstract provided.

Management Of Hyperkalemia To Prevent Cardiac Arrest, Jennifer Harklerode, Amber Paul, Crystal Zheng, Olivia Vanscoy, Olivia Henton, Mark Olah

Pharmacy and Wellness Review

Hyperkalemia is a metabolic problem that may be life threatening if left untreated. Cardiac arrhythmias may develop with the potential to lead to cardiac arrest and death. Hyperkalemia can oftentimes be undiagnosed due to the lack of clear, specific symptoms and inconclusive variations in electrocardiogram (ECG) readings and lab values. Therefore, it is important to recognize risk factors that can potentially in-crease serum potassium levels. Screening for medications that increase serum potassium levels and educating patients are steps that both inpatient and outpatient health care professionals can take to increase early detection and prevention of a hyperkalemic episode. It is …

Conference Proceedings: Select Abstracts Presented At 2021 Advocate Aurora Health Scientific Day

Journal of Patient-Centered Research and Reviews

Abstracts published within this supplement were presented at the 47th annual Advocate Aurora Health Scientific Day, held virtually on May 26, 2021. This research symposium provides a forum for disseminating results from studies conducted by faculty, fellows, residents, and other allied health professionals associated with Midwest-based health system Advocate Aurora Health, which publishes the Journal of Patient-Centered Research and Reviews.

Pharmacists’ Role In The Management Of Patients Receiving Dual Or Triple Antithrombotic Therapy, Laura Neubauer, Radhan Gopalani, Kristen De Almeida

All Publications

Purpose: Patients on dual and triple antithrombotic therapy present the therapeutic dilemma of mitigating bleed risk while sustaining antithrombotic efficacy. Lack of literature and variability in existing published guidance potentiates inconsistent management of these patients. Furthermore, suboptimal dosing of direct oral anticoagulants is relatively common. One study reported as high as 43% of patients receive higher and 13% receive lower than clinically indicated doses. These findings were associated with a significantly increased risk of major bleeding and incidence of stroke, thus highlighting the importance of selecting an ideal regimen. The purpose of this project is to highlight pharmacists’ role in …

Home Blood Pressure Monitoring To Improve Hypertension Control: A Narrative Review Of International Guideline Recommendations, John Andraos, Luma Munjy, Michael S. Kelly

Pharmacy Faculty Articles and Research

Home blood pressure monitoring (HBPM) is a convenient way to assess out-of-office blood pressure control and is recommended by numerous international guidelines to aid clinicians in the diagnosis and management of essential hypertension. Although available guidelines recommend the use of HBPM in patients receiving antihypertensive medication, their specific recommendations regarding optimal monitoring schedule, duration, and clinician interpretation of home blood pressure readings may differ among guidelines. Purpose: The purpose of this article is to review available international hypertension guideline recommendations related to the use of HBPM to improve hypertension control among patients receiving antihypertensive therapy. We also briefly highlight …